Ehrlichiosis

Canine Monocytic Ehrlichiosis, Canine Rickettsiosis, Canine

Hemorrhagic Fever, Tropical Canine Pancytopenia, Tracker Dog
Disease, Canine Tick Typhus, Nairobi Bleeding Disorder,
Canine Granulocytic Ehrlichiosis,
Equine Monocytic Ehrlichiosis, Potomac Horse Fever, Equine
Granulocytic Ehrlichiosis, Tick-borne Fever,
Human Monocytic Ehrlichiosis, Human Granulocytic Ehrlichiosis,
Sennetsu Fever, Glandular Fever
 Overview
• Organism
• History
• Epidemiology
• Transmission
• Disease in Humans
• Disease in Animals
• Prevention and Control

Center for Food Security and Public Health, Iowa State University, 2013
THE ORGANISM
 The Organism(s)
• Coccobacilli
– Small, pleomorphic
– Gram negative
– Obligate intracellular
• Three intracytoplasmic forms
– Initial body
– Elementary body
– Morula

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 Zoonotic Species
• Ehrlichia chaffeensis
• Ehrlichia ewingii
• Anaplasma phagocytophilum
• Neorickettsia sennetsu
• Ehrlichia canis (possibly)

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 Non-zoonotic Species
• Ehrlichia bovis
• Ehrlichia muris
• Ehrlichia ondiri
• Ehrlichia ovina
• Ehrlichia ruminantium
• Anaplasma platys
• Neorickettsia risticii

Center for Food Security and Public Health, Iowa State University, 2013
 Ehrlichial Diseases
Disease
Canine monocytic ehrlichiosis
Canine granulocytic ehrlichiosis
Equine monocytic ehrlichiosis
(Potomac horse fever)
Equine granulocytic ehrlichiosis
Tick-borne fever
Human monocytic ehrlichiosis
Human granulocytic ehrlichiosis
Sennetsu fever
Causative Agent
Ehrlichia canis
Ehrlichia chaffeensis
Anaplasma phagocytophilum
Ehrlichia ewingii
Neorickettsia risticii
Anaplasma phagocytophilum
Anaplasma phagocytophilum
Ehrlichia chaffeensis
Ehrlichia ewingii
Anaplasma phagocytophilum
Neorickettsia sennetsu
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HISTORY
 History
• 1950s
– Human infections with Neorickettsia
sennetsu reported
• 1980s
– New species recognized in humans
• Ehrlichia chaffeensis
• E. ewingii
• Anaplasma phagocytophilum

Center for Food Security and Public Health, Iowa State University, 2013
EPIDEMIOLOGY
 Geographic Distribution
• Worldwide
– E. chaffeensis, E. canis,
A. phagocytophilum
• Southeast/south central U.S.
– E. ewingii
• Japan, Malaysia
– E. sennetsu

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 Seasonality
• Dogs
– No seasonal variation
– Disease occurs
throughout the year
• Horses
– Late fall, winter, spring
– California
• Cattle (tick-borne fever)
– Spring, early summer
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Incidence in Humans

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TRANSMISSION
 Transmission
• Ticks (family Ixodidae)
– Ehrlichia canis
• Rhipicephalus sanguineus
– Brown dog tick
• Dermacentor variablis
– American dog tick
– E. chaffeensis
• Amblyomma americanum
– Lone Star tick
– E. ewingii
• Amblyomma americanum
• Dermacentor variablis
• Rhipicephalus sanguineus

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 Transmission
• Anaplasma phagocytophilum
– Ixodes scapularis
• Black-legged tick
– I. pacificus
– I. ricinus
• Neorickettsia sennetsu
– Unknown
• Ehrlichia spp. also transmitted by
blood transfusions, biting insects
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DISEASE IN HUMANS
 Disease in Humans
• Wide spectrum of disease
– Human monocytic ehrlichiosis
– Human granulocytic ehrlichiosis
• Symptoms often non-specific
– Headache, fever, malaise
– Gastrointestinal signs
– Rash on trunk, legs, arms, face
• Severe if immunocompromised

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 Disease in Humans
• Sennetsu fever
– Mild disease
– Resembles mononucleosis
• Ehrlichia ewingii
– Reported in immunocompromised
• E. canis
– May rarely be zoonotic

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 Diagnosis
• Initial diagnosis
– History, clinical signs
– Hematologic abnormalities
– Serum chemistry
• Definitive diagnosis
– IFA
– ELISA
– PCR
– Culture

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 Treatment
• Antibiotics
– Tetracyclines
• Doxycycline
– Early treatment critical
– Prolonged therapy may be necessary
in severe or complicated cases

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DISEASE IN ANIMALS
 Species Affected
• E. chaffeensis
– Dogs, coyotes, red foxes,
goats, deer (reservoir)
• E. ewingii
– Dogs (reservoir)
• E. canis
– Dogs, wolves, jackals (reservoir)

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 Species Affected
• A. phagocytophilum
– Dogs, horses, llamas, cats, cattle
– Deer, elk, rodents (reservoirs)
• E. sennetsu
– Dogs

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 Canine Monocytic
Ehrlichiosis
• Caused by E. canis, E. chaffeensis
• Early signs often non-specific
• May cause:
– Bleeding disorders
– Ocular signs
– Renal failure
– Reproductive disorders
– Neurological disease
– Death

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 Canine Granulocytic
Ehrlichiosis
• Caused by:
– Anaplasma phagocytophilum
– Ehrlichia ewingii
• Resembles monocytic ehrlichiosis
• But, often includes polyarthritis

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 Sennetsu Fever
• Caused by:
– Neorickettsia sennetsu
• Experimental infections
– Dogs
• Transient fever
– Mice
• Diarrhea, weakness,
lymphadenopathy, death

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 Equine Granulocytic
Ehrlichiosis
• Caused by:
– Anaplasma phagocytophilum
• Wide spectrum of disease
– Often begins as non-specific illness
– Signs increase in severity
– May include icterus, petechiation,
reluctance to move, distal limb edema

Center for Food Security and Public Health, Iowa State University, 2013
 Tick-borne Fever
• Caused by:
– Anaplasma phagocytophilum
• Affects domestic and wild ruminants
• Occurs in tick-infested areas
– Newly introduced animals affected
• Clinical signs variable
– Fever, abortion (sheep)
– Reduced milk yield, respiratory (cattle)

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Ehrlichiosis in Other Species
• Cats
– Documented cases rare
• Under-reporting?
• Cats less susceptible to disease?
– Granulocytic form reported
• Non-human primates
– Natural infections reported in lemurs
– Experimental infection
• Rhesus macaques
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 Post Mortem Lesions
• Canine ehrlichiosis
– Splenomegaly
– Lymphadenopathy
– Heavy, discolored lungs
– Hemorrhages
• Equine granulocytic ehrlichiosis
– Hemorrhages
– Interstitial pneumonia

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 Diagnosis
• Serology
– IFA
• Equine granulocytic ehrlichiosis
• Canine ehrlichiosis, tick-borne fever
– ELISA
• Blood smears
• Hematologic abnormalities
– Thrombocytopenia
• Changes in serum chemistry
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 Treatment
• Antibiotics
– Tetracyclines
– Chloramphenicol
• Early treatment critical for dogs
• Persistent infections may occur
– Ehrlichia canis
– E. chaffeensis

Center for Food Security and Public Health, Iowa State University, 2013
PREVENTION AND
CONTROL
 Prevention and Control
• Prevent tick bites
– Wear protective footwear, clothing
– Use insect repellents
– Remove ticks as soon as possible

Center for Food Security and Public Health, Iowa State University, 2013
 Prevention and Control
• Control tick vectors
– Remove ticks from pets
– Acaricides
• Pets, livestock, environment
• Manage tick habitats
• No vaccine available
– Canine ehrlichiosis
– Equine granulocytic ehrlichiosis
– Tick-borne fever

Center for Food Security and Public Health, Iowa State University, 2013
 Additional Resources
• Center for Food Security and Public Health
– www.cfsph.iastate.edu
• CDC: Ehrlichiosis
– www.cdc.gov/ehrlichiosis/

Center for Food Security and Public Health, Iowa State University, 2013
 Acknowledgments
Development of this presentation was made possible
through grants provided to
the Center for Food Security and Public Health at Iowa
State University, College of Veterinary Medicine from
the Centers for Disease Control and Prevention,
the U.S. Department of Agriculture,
the Iowa Homeland Security and
Emergency Management Division, and the
Multi-State Partnership for Security in Agriculture.

Authors: Kerry Leedom Larson, DVM, MPH, PhD, DACVPM; Anna Rovid Spickler, DVM,
PhD
Reviewers: Glenda Dvorak, DVM, MPH, DACVPM

Center for Food Security and Public Health, Iowa State University, 2013